Alcohol Study - FHI

Reducing Alcohol Harm Amongst Female Sex Workers

ICRH-K conducted a research intervention cohort study on Alcohol Harm Reduction Intervention with FSWs in Mombasa, Kenya between February 2011 and September 2012. The study was carried out in partnership with Family Health International and sponsored by the Public Health Evaluation (PHE) component of the President’s Emergency Plan for AIDS Relief (PEPFAR).

The objective of the study was to investigate whether FSWs at Drop-in-Centers in Mombasa, Kenya who reported harmful or hazardous alcohol intake and participated in a brief alcohol inter- vention will reduce their alcohol intake use and incidence of STIs, HIV and sexual violence as well as increase condom use.

This was a two-arm longitudinal comparative research/inter- vention study among FSWs who were recruited at three DICs (Kisauni, Chaani and Likoni) through APHIA II/Plus and must have exhibited moderate drinking. After more than 6 months of competitive screening total of 1953 participants had been screened, of which 818 FSWs with harmful or hazardous alcohol use were enrolled into the 12 months follow-up study. Once recruited the participants were randomly assigned into either In- tervention or ‘active’ Control arm. The Intervention Arm received ‘Brief Intervention’ for Alcohol Use (BI) designed for individuals with harmful or hazardous alcohol use. The Control Arm received only non-alcohol related information about nutrition. This was done over a six months one-on-one counseling session with study staff.

A few challenges were experienced during the study including low participant turn out for scheduled visits because of the nature of their work (high mobility, working hours), travelling out of the country to look for alternative sources of income, going back home, i.e. relocating or not being able to return citing lack of money and others getting married. The Principal Investigator ensured close monitoring by holding weekly meetings with study team to discuss progress, implementation and addressing the challenges experienced. Also the study sites remained open past working hours, the protocol was reviewed to extend the window period and some were facilitated to come for their visits. During the study some felt they were in the wrong arm of the study.

Quality assurance was an integral part of this intervention study and the study coordinator visited all the three study sites for qual- ity checks on all completed CRFs before being checked by the quality assurance officer. Participant visit ended September 2012 and study officially closed October 2012. Data collection, entry and cleaning for mid and end-term evaluations were completed in April and December 2012 respectively and are being analyzed. A retention rate of 86.7% (n=709) was realized surpassing the expected 73% Prior collaboration with the key-players (Sex workers themselves) and alliance with salient group like the peer educators (PE) was important for the successful implementation of the study and commendable participant retention.

Data are currently (2013) being analyzed and will be published in due course